From Visit to Payment — One Visible Process
Move claims from documentation and review through submission, posting, and follow-up with clear ownership at each step.
Review Claims Before
They Leave the Practice
Use a structured review queue for coding, modifiers, payer edits, provider information, and submission readiness. Your team keeps final control over corrections and release.
- CPT and ICD-10 compatibility validation
- Modifier logic and unbundling checks
- Payer-specific editing rules
- EDI 837P submission via clearinghouse
- ERA posting and reconciliation workflow
- Secondary claim preparation after primary response
- NPI and taxonomy validation
- Eligibility details available during review
Demonstration Claim A
Coding and payer edits reviewed
Demonstration Claim B
Charge detail and modifier reviewed
Demonstration Claim C
Modifier requires team review
Organize Denial Review and Follow-Up
Keep CARC/RARC details, supporting documents, appeal templates, owners, due dates, and rework status together.
Suggested action: Resubmit with RARC M144 — check for duplicate billing or bundling conflict with primary CPT. Appeal template generated.
Suggested action: Add 25 modifier for E&M on same day as procedure, or correct to appropriate E&M level. One-click correction available.
Prior Authorization Workspace
Organize requirements, supporting documentation, submission details, due dates, and payer responses in one reviewable workflow.
Requirement Review
Record the service, payer, policy details, and authorization requirements identified by the team.
Clinical Documentation Assembly
Collect relevant notes, diagnosis history, prior treatments, results, and photos for staff and provider review.
Supporting Letter
Use an editable template to prepare the supporting rationale. The provider reviews and approves the final document.
Payer Submission
Document the submission channel, confirmation, owner, and next follow-up date.
Approval & Expiration Tracking
Store the decision, reference number, effective dates, and renewal task in the patient record.
Eligibility Details
at Check-In
Give staff one place to review coverage details, deductible, copay, coinsurance, effective dates, and network information before the visit.
- Coverage response and verification details
- Deductible, copay, and coinsurance display
- Out-of-pocket maximum tracking
- Pre-visit verification work queue
- Secondary insurance coordination
- Coverage effective date validation
- Network status (in/out of network)
- Primary and secondary coverage review
Accounts Receivable Aging Dashboard
Color-coded aging buckets help the billing team prioritize follow-up. The example below is illustrative, not a customer result.
| Bucket | Claims | Amount | % of A/R | Visual |
|---|---|---|---|---|
| 0–30 days | 142 | $48,220 | 54% | |
| 31–60 days | 48 | $18,450 | 21% | |
| 61–90 days | 21 | $9,870 | 11% | |
| 91–120 days | 14 | $6,340 | 7% | |
| 120+ days | 9 | $6,120 | 7% |
Modern Patient Payment Experience
Support card-on-file, payment links, payment-plan tracking, statements, and portal balances in a consistent patient-facing process.
Card on File
Securely store payment method for seamless post-visit collections.
Payment Links
Send a payment link for patients to open on a supported device.
Payment Plans
Offer flexible installment plans for larger balances, auto-charged.
Auto-Statements
Automated patient statements by email, SMS, or paper — on a schedule.
Planning Estimate
Share an estimate based on available coverage and service information.
Patient Portal Pay
Patients view and pay balances anytime from the patient portal.
Revenue Analytics by Provider,
Payer & Procedure
Review revenue activity by provider, payer, procedure, and date range. The figures shown below demonstrate the layout only.
Bring Revenue Work Into Focus
See how OAK EMR can organize billing tasks, surface status, and give your team a clearer follow-up process.